AORTIC STENOSIS—Surgical Treatment Under Direct Vision,Using the Heart-Lung Machine

Cardiac operation with the operative field under direct vision and the patient''s oxygenation maintained by a heart-lung machine affords an excellent means of treating aortic stenosis, for it allows unlimited time in which to repair aortic stenosis no matter how involved the cusps are with calcium. The valves can be sculptured and the commissures cut at their place of fusion. Concomitant aortic insufficiency can also be taken care of at the same time, as can associated mitral valve stenosis and insufficiency.This method was used in ten patients. Two died. Eight were considerably improved.     

A question of rhythm: recent advances in growth hormone research.

Research by Dr. Gloria Shaffer Tannenbaum at the McGill University-Montreal Children''s Hospital Research Institute has led to the development of a new test to differentiate children who are deficient in growth hormone from those who are short but growing normally. This clinical application is the fruit of Tannenbaum''s discovery that growth hormone secretion occurs in a rhythmic pattern regulated by intricate interactions between two neurohormones: growth hormone-releasing hormone (GHRH) and somatotropin release-inhibiting factor (SRIF). In the test an analogue of SRIF is used to allow stores of growth hormone to build up. A subsequent challenge with GHRH is then used to identify children with a genuine deficiency. Tannenbaum''s research also indicates that there are sexual differences in the pattern of growth hormone release and that growth hormone regulates its own secretion by means of a negative feedback system.     

Analysing gait using a force-measuring walkway: intrasession repeatability in healthy children and adolescents

The goal of this study was to determine the repeatability of gait parameters measured by a force plate gait analysis system (Leonardo Mechanograph^® GW) in healthy children. Nineteen healthy children and adolescents (age range: 7–17 years) walked at a self-selected speed on an 11-m-long walkway. Vertical ground reaction forces were measured in the central 6 m of the walkway. Each participant performed three blocks of three trials while walking barefoot and three blocks of three trials while wearing shoes. There were no differences between trials within each condition. All force and spatiotemporal parameters had intraclass correlation coefficients above 0.87 and coefficients of variation in the order of 1–6%. In this group of healthy children and adolescents, gait analysis with a force plate system produced repeatable intra-day results.     

Cultural Identity and Internationally Adopted Children: Qualitative Approach to Parental Representations

Approximately 30 000 children are adopted across national borders each year. A review of the literature on the cultural belonging of these internationally adopted children shows substantial differences between the literature from English-speaking countries and that from France and Europe in general. The objective of this study is to start from the discourse of French adoptive parents to explore their representations of their child''s cultural belonging and their positions (their thoughts and representations) concerning connections with the child''s country of birth and its culture. The study includes 51 French parents who adopted one or more children internationally. Each parent participated in a semi-structured interview, focused on the adoption procedure and their current associations with the child''s birth country. The interviews were analyzed according to a qualitative phenomenological method, Interpretative Phenomenological Analysis. The principal themes that emerged from our analysis of the interviews made it possible to classify the parents into three different groups. The first group maintained no association with the child''s country of birth and refused any multiplicity of cultural identities. The second group actively maintained regular associations with the child''s country of birth and culture and affirmed that their family was multicultural. Finally, the third group adapted their associations with the child''s birth country and its culture according to the child''s questions and interests. Exploring parental representations of the adopted child enables professionals involved in adoption to provide better support to these families and to do preventive work at the level of family interactions.     

Paternal preconceptional radiation exposure in the nuclear industry and leukaemia and non-Hodgkin's lymphoma in young people in Scotland.

OBJECTIVE--To determine if a relation exists between paternal exposure to relatively high levels of radiation in the Scottish nuclear industry and the risk of leukaemia and non-Hodgkin''s lymphoma is subsequently conceived children. DESIGN--Matched case-control study with three controls for each case. SETTING--The whole of Scotland. SUBJECTS--The fathers of 1024 children with leukaemia and 237 children with non-Hodgkin''s lymphoma diagnosed in Scotland below the age of 25 among those born in Scotland since nuclear operations began (in 1958) and the fathers of 3783 randomly chosen controls. The fathers of 80 children with leukaemia and 16 with non-Hodgkin''s lymphoma in north Cumbria were also covered since some workers at one Scottish nuclear site live over the border in that area. Details of all fathers were then matched against records of the nuclear industry. MAIN OUTCOME MEASURES--Paternal preconceptional radiation exposures, particularly relatively high levels, both lifetime and in the six and three months before conception. RESULTS--No significant excess was observed in any subgroup and there was no significant trend: fathers of three controls but no cases were exposed to lifetime preconceptional levels of 100 mSv or greater (Fisher''s exact p value 0.84). In the six months before conception, fathers of two cases and three controls received 10 mSv or more, odds ratio 2.3 (95% confidence interval 0.31 to 17.24). In the three months before conception the fathers of one case and two controls received 5 mSv or more, odds ratio 1.7 (0.10 to 30.76). The results for leukaemia and non-Hodgkin''s lymphoma combined were similar. CONCLUSIONS--No significant excess of leukaemia or of leukaemia and non-Hodgkin''s lymphoma was found at any radiation level in any preconceptional period.     

National surveillance program on occupational exposure to the human immunodeficiency virus among health care workers in Canada.

To determine the accuracy of various predictors of school problems, we conducted a 3-year prospective study of 1999 children who began school in the Niagara region of Ontario in 1980. During the year before school entry the parents gave a health, developmental and behavioural history during an interview with a community health nurse, and the children underwent vision and hearing screening tests and the Denver Developmental Screening Test (DDST). At the end of the 1980-81 school year the kindergarten teachers rated the children''s learning problems. At the end of the 1982-83 school year the presence of school problems was ascertained, and the predictive accuracy of items from the preschool history and examination and of the kindergarten teachers'' ratings was calculated. The health, developmental and behavioural history with or without the DDST was found to predict later school problems with acceptable accuracy. The kindergarten teachers'' ratings gave slightly more accurate predictions. We conclude that in communities where prompt diagnostic evaluation and effective therapeutic or preventive help can be provided to children identified as being at high risk, health professionals may play a useful role in screening for future school problems.     

Neural Activity during Natural Viewing of Sesame Street Statistically Predicts Test Scores in Early Childhood

It is not currently possible to measure the real-world thought process that a child has while observing an actual school lesson. However, if it could be done, children''s neural processes would presumably be predictive of what they know. Such neural measures would shed new light on children''s real-world thought. Toward that goal, this study examines neural processes that are evoked naturalistically, during educational television viewing. Children and adults all watched the same Sesame Street video during functional magnetic resonance imaging (fMRI). Whole-brain intersubject correlations between the neural timeseries from each child and a group of adults were used to derive maps of “neural maturity” for children. Neural maturity in the intraparietal sulcus (IPS), a region with a known role in basic numerical cognition, predicted children''s formal mathematics abilities. In contrast, neural maturity in Broca''s area correlated with children''s verbal abilities, consistent with prior language research. Our data show that children''s neural responses while watching complex real-world stimuli predict their cognitive abilities in a content-specific manner. This more ecologically natural paradigm, combined with the novel measure of “neural maturity,” provides a new method for studying real-world mathematics development in the brain.     

The scope and limits of overimitation in the transmission of artefact culture

Children are generally masterful imitators, both rational and flexible in their reproduction of others'' actions. After observing an adult operating an unfamiliar object, however, young children will frequently overimitate, reproducing not only the actions that were causally necessary but also those that were clearly superfluous. Why does overimitation occur? We argue that when children observe an adult intentionally acting on a novel object, they may automatically encode all of the adult''s actions as causally meaningful. This process of automatic causal encoding (ACE) would generally guide children to accurate beliefs about even highly opaque objects. In situations where some of an adult''s intentional actions were unnecessary, however, it would also lead to persistent overimitation. Here, we undertake a thorough examination of the ACE hypothesis, reviewing prior evidence and offering three new experiments to further test the theory. We show that children will persist in overimitating even when doing so is costly (underscoring the involuntary nature of the effect), but also that the effect is constrained by intentionality in a manner consistent with its posited learning function. Overimitation may illuminate not only the structure of children''s causal understanding, but also the social learning processes that support our species'' artefact-centric culture.     

基于社交媒体数据的城市公园景感评价

城市公园是城市居民与自然生态系统互动的主要场所,为居民提供重要的生态系统服务。从景感生态角度和方法对城市公园文化服务进行评价,需要掌握大量居民个体对城市公园的感知、感受信息。随着现代信息技术和人们生活方式的发展,社交媒体成为大众获取信息、发布观点的主要方式之一。社交媒体数据具有数据易于获取、时间跨度长、数据量大等优势,同时,通过对社交媒体信息进一步进行文本提取与分析,还可以获取用户对特定活动场所更为具体的感知和感受,因此,社交媒体数据为城市公园景感评价提供了有价值的新的数据来源和手段。构建了基于社交媒体数据的城市公园景感评价框架和流程、评价指标以及信息提取方法,包括对获取数据进行预处理;构建感官感知及公园要素词库;通过情感分类,形成积极和消极情感文本,表征用户对文本关联景感要素的满意度;将各类情感文本分别进行要素及其对应感知感官的统计,以频率衡量景感要素对用户感知的重要性;在此基础上,基于重要性-绩效分析(IPA)方法构建了感知评价模型。最后,以北京玉渊潭公园为例,进行了实证研究。结果表明:视觉在居民对城市公园的感知体验中占据主导地位,触觉感知次之,听觉感知普遍不被重视,而嗅觉感知评价...     

Effects of Doubling the Portion Size of Fruit and Vegetable Side Dishes on Children's Intake at a Meal

Increasing the portion size of energy‐dense entrées has been shown to increase children's energy intake during a meal. It remains to be investigated whether serving larger portions to children can be used to promote intake of more healthful foods, such as fruits and vegetables (F&V). The aim of the present study was to examine the effects of increasing the portion size of F&V side dishes on children's intake. Forty‐three children (22 boys, 21 girls), aged 5–6 years, were served dinner once a week for 2 weeks. Each dinner consisted of pasta with tomato sauce, three F&V side dishes (broccoli, carrots, and applesauce), and milk. The portion size of the F&V was doubled between experimental conditions whereas the size of the pasta remained constant. Doubling the portion size of the side dishes resulted in a 43% increase in children's intake of the fruit side dish (P = 0.001), but did not affect children's intake of the two vegetable side dishes (P > 0.60). Further, when the portion size of F&V side dishes was doubled, children ate significantly less of the pasta (P = 0.04). The difference in meal energy intake between portion size conditions (19.5 ± 16.3 kcal) was not significant (P = 0.24). Although more studies are needed to understand whether increases in portion size can influence vegetable intake, children did eat more in response to a large quantity of a preferred low energy‐dense fruit side dish at meals. Thus variations in portion size can be used strategically to help children achieve the recommended intake of fruits.     

Psychological disturbance in children with haemophilia.

OBJECTIVE--To assess the need for formal psychotherapeutic intervention in children attending a children''s haemophilia clinic after some of them had been diagnosed as positive for HIV. DESIGN--Comparison of haemophiliac children with matched control groups of diabetic and healthy children. SETTING--The West of Scotland Children''s Haemophilia Centre, Glasgow. PATIENTS--43 Children aged 3 to 16 years with mild, moderate, and severe clotting disorders were matched with control groups of 46 diabetic children and 42 physically healthy children. INTERVENTIONS--Parents of children aged 3-5 years were interviewed with the behaviour screening questionnaire. Children aged 6 to 16 were assessed by parental and teacher report using standardised questionnaires and self report using a computerised depression inventory. All were scored numerically according to the presence of symptoms of emotional and behavioural problems. MAIN OUTCOME MEASURES--The groups were compared for mean scores on each rating device and for number of children achieving scores within the pathological range. RESULTS--In the 6-16 age group five haemophiliac children, five diabetic children, and three healthy children scored in the pathological range on the parent questionnaire, as did two, three, and five respectively on the teacher questionnaire and four, four, and eight on the depression inventory. There was no significant difference across the three groups. Analysis of mean scores similarly showed no significant difference across groups. In contrast, the single measure used for younger children showed an increase in behavioural difficulties among the diabetic children. CONCLUSION--Haemophiliac children attending the West of Scotland Centre were no more disturbed than their diabetic or healthy peers despite the identification of HIV infection within the clinic and the widespread adverse publicity associated with AIDS and HIV infection.     

Knowledge-based vision and simple visual machines.

The vast majority of work in machine vision emphasizes the representation of perceived objects and events: it is these internal representations that incorporate the ''knowledge'' in knowledge-based vision or form the ''models'' in model-based vision. In this paper, we discuss simple machine vision systems developed by artificial evolution rather than traditional engineering design techniques, and note that the task of identifying internal representations within such systems is made difficult by the lack of an operational definition of representation at the causal mechanistic level. Consequently, we question the nature and indeed the existence of representations posited to be used within natural vision systems (i.e. animals). We conclude that representations argued for on a priori grounds by external observers of a particular vision system may well be illusory, and are at best place-holders for yet-to-be-identified causal mechanistic interactions. That is, applying the knowledge-based vision approach in the understanding of evolved systems (machines or animals) may well lead to theories and models that are internally consistent, computationally plausible, and entirely wrong.     

西安地区儿童支气管哮喘吸入性过敏原的调查分析

目的:探讨西安地区儿童支气管哮喘吸入性过敏原的分布情况。方法:选择950例来自西安地区的支气管哮喘患儿为研究对象,采用过敏原皮肤点刺试验检测,以组胺作为阳性对照,生理盐水为阴性对照,分析不同年龄和性别的患儿过敏原的分布情况。结果:950例支气管哮喘患儿中,384例皮肤点刺过敏原检测呈阳性,占40.4%,男女患儿过敏原检测阳性分布无明显差异(P0.05);尘螨为主要的过敏原,其次为艾蒿和霉菌类;随着患儿年龄的增加,其过敏原检测的阳性率明显升高(P0.05),且大多数过敏原检测阳性患儿至少合并2-3种过敏原阳性。结论:西安地区支气管哮喘患儿吸入性过敏原阳性率与其性别无关,但与其年龄有关,过敏原以尘螨类为主,大多数检测阳性的患儿对至少一种以上的过敏原阳性。     

Model-based interpretation of complex and variable images.

The ultimate goal of machine vision is image understanding-the ability not only to recover image structure but also to know what it represents. By definition, this involves the use of models which describe and label the expected structure of the world. Over the past decade, model-based vision has been applied successfully to images of man-made objects. It has proved much more difficult to develop model-based approaches to the interpretation of images of complex and variable structures such as faces or the internal organs of the human body (as visualized in medical images). In such cases it has been problematic even to recover image structure reliably, without a model to organize the often noisy and incomplete image evidence. The key problem is that of variability. To be useful, a model needs to be specific-that is, to be capable of representing only ''legal'' examples of the modelled object(s). It has proved difficult to achieve this whilst allowing for natural variability. Recent developments have overcome this problem; it has been shown that specific patterns of variability in shape and grey-level appearance can be captured by statistical models that can be used directly in image interpretation. The details of the approach are outlined and practical examples from medical image interpretation and face recognition are used to illustrate how previously intractable problems can now be tackled successfully. It is also interesting to ask whether these results provide any possible insights into natural vision; for example, we show that the apparent changes in shape which result from viewing three-dimensional objects from different viewpoints can be modelled quite well in two dimensions; this may lend some support to the ''characteristic views'' model of natural vision.     

Young Children's Probability of Dying Before and After Their Mother's Death: A Rural South African Population-Based Surveillance Study

Background

There is evidence that a young child''s risk of dying increases following the mother''s death, but little is known about the risk when the mother becomes very ill prior to her death. We hypothesized that children would be more likely to die during the period several months before their mother''s death, as well as for several months after her death. Therefore we investigated the relationship between young children''s likelihood of dying and the timing of their mother''s death and, in particular, the existence of a critical period of increased risk.

Methods and Findings

Data from a health and socio-demographic surveillance system in rural South Africa were collected on children 0–5 y of age from 1 January 1994 to 31 December 2008. Discrete time survival analysis was used to estimate children''s probability of dying before and after their mother''s death, accounting for moderators. 1,244 children (3% of sample) died from 1994 to 2008. The probability of child death began to rise 6–11 mo prior to the mother''s death and increased markedly during the 2 mo immediately before the month of her death (odds ratio [OR] 7.1 [95% CI 3.9–12.7]), in the month of her death (OR 12.6 [6.2–25.3]), and during the 2 mo following her death (OR 7.0 [3.2–15.6]). This increase in the probability of dying was more pronounced for children whose mothers died of AIDS or tuberculosis compared to other causes of death, but the pattern remained for causes unrelated to AIDS/tuberculosis. Infants aged 0–6 mo at the time of their mother''s death were nine times more likely to die than children aged 2–5 y. The limitations of the study included the lack of knowledge about precisely when a very ill mother will die, a lack of information about child nutrition and care, and the diagnosis of AIDS deaths by verbal autopsy rather than serostatus.

Conclusions

Young children in lower income settings are more likely to die not only after their mother''s death but also in the months before, when she is seriously ill. Interventions are urgently needed to support families both when the mother becomes very ill and after her death. Please see later in the article for the Editors'' Summary     

Mental Health of Parents as Caregivers of Children with Disabilities: Based on Japanese Nationwide Survey

The number of children with disability is increasing gradually in Japan. Previous researches in other countries have reported that parents as caregivers (CGs) of children with disability have mental health problems, but the actual situation has not been examined nationwide in Japan so far. The aim of this study was to evaluate the association between mental health of CGs who had children with disability and characteristics of children, CGs, and household based on the nation-wide survey. This study utilized data from 2010 Comprehensive Survey of the Living Conditions, and defined children with disability aged 6 to 17. Individual data of children and CGs were linked, and 549 pairs of them were extracted. The Japanese version of Kessler 6 (K6) was used to assess mental health status of caregiver, scored 5 and over represented to general psychological distress. Logistic regression was used to evaluate the associations of interest. The almost half (44.4%) of CGs had psychological distress (k6 score; 5 +) in nationwide, and 8.9% of CGs might have serious mental illness (K6 score; 13+). After adjusting covariates of child, CG, and household factors, CG having a current symptom (OR, 95% CI: 3.26, 1.97–5.39), CG''s activity restriction (OR, 95% CI: 2.95, 1.38–6.32), low social support (OR, 95%CI: 9.31, 1.85–46.8), three generation family (OR, 95% CI: 0.49, 0.26–0.92), and lower 25% tile group of monthly household expenditure (OR, 95% CI:1.92, 1.05–3.54), were significantly associated with psychological distress of CGs. This study encourages health care providers to pay more attentions toward parent''s mental health, especially for in case of having low social support, and lower income family. Further research should examine the detailed information of child''s disease and disability, medical service use, and quality and quantity of social support in nationwide to straighten the system for supporting services of both children with disabilities and their CGs.     

Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria.

OBJECTIVE--To examine whether the observed excess of childhood leukaemia and lymphoma near the Sellafield nuclear plant is associated with established risk factors or with factors related to the plant. DESIGN--A case-control study. SETTING--West Cumbria health district. SUBJECTS--52 Cases of leukaemia, 22 of non-Hodgkin''s lymphoma, and 23 of Hodgkin''s disease occurring in people born in the area and diagnosed there in 1950-85 under the age of 25 and 1001 controls matched for sex and date of birth taken from the same birth registers as the cases. MAIN OUTCOME MEASURES--Antenatal abdominal x ray examinations, viral infections, habit factors, proximity to and employment characteristics of parents at Sellafield. RESULTS--Expected associations with prenatal exposure to x rays were found, but little information was available on viral illnesses. Relative risks for leukaemia and non-Hodgkin''s lymphoma were higher in children born near Sellafield and in children of fathers employed at the plant, particularly those with high radiation dose recordings before their child''s conception. For example, the relative risks compared with area controls were 0.17 (95% confidence interval 0.05 to 0.53) for being born further than 5 km from Sellafield 2.44 (1.04 to 5.71) for children of fathers employed at Sellafield at their conception, and 6.42 (1.57 to 26.3) for children of fathers receiving a total preconceptual ionising radiation dose of 100 mSv or more. Other factors, including exposure to x rays, maternal age, employment elsewhere, eating seafood, and playing on the beach did not explain these relationships. Focusing on Seascale, where the excess incidence has predominantly been reported, showed for the four out of five cases of leukaemia and one case of non-Hodgkin''s lymphoma whose fathers were employed at Sellafield and for whom dose information was obtained that the fathers of each case had higher radiation doses before their child''s conception than all their matched control fathers; the father of the other Seascale case (non-Hodgkin''s lymphoma) was not employed at the plant. These results seem to explain statistically the geographical association. For Hodgkin''s disease neither geographical nor employment associations with Sellafield were found. CONCLUSIONS--The raised incidence of leukaemia, particularly, and non-Hodgkin''s lymphoma among children near Sellafield was associated with paternal employment and recorded external dose of whole body penetrating radiation during work at the plant before conception. The association can explain statistically the observed geographical excess. This result suggests an effect of ionising radiation on fathers that may be leukaemogenic in their offspring, though other, less likely, explanations are possible. There are important potential implications for radiobiology and for protection of radiation workers and their children.     

Lawnmower injuries in children.

Over an 8-year period 31 children in the Winnipeg area were admitted to hospital with lawnmower injuries. The accidents were always preventable and were caused by patient or parent carelessness. The wounds were severe, often resulting in amputation of a portion of an extremity. Infection was common; prophylaxis with a broad-spectrum antibiotic and human antitetanus globulin is recommended. Radiography, débridement of the wound with thorough exploration under general anesthesia, and defatting and reapplication of degloved skin should be done initially, then the wound should be reinspected and redressed at 2 to 3 days, and finally closed or skin grafted at 6 to 8 days. Children must be educated about the dangers of lawnmowers and prevented from riding on tractor mowers. The grass catcher should be used and the path cleared of missiles. Hand controls should be mounted on the mower''s handle and the blade should be kept sharp so that the machine''s speed can be reduced.     

Weather Effects on the Patterns of People's Everyday Activities: A Study Using GPS Traces of Mobile Phone Users

This study explores the effects that the weather has on people''s everyday activity patterns. Temperature, rainfall, and wind speed were used as weather parameters. People''s daily activity patterns were inferred, such as place visited, the time this took place, the duration of the visit, based on the GPS location traces of their mobile phones overlaid upon Yellow Pages information. Our analysis of 31,855 mobile phone users allowed us to infer that people were more likely to stay longer at eateries or food outlets, and (to a lesser degree) at retail or shopping areas when the weather is very cold or when conditions are calm (non-windy). When compared to people''s regular activity patterns, certain weather conditions affected people''s movements and activities noticeably at different times of the day. On cold days, people''s activities were found to be more diverse especially after 10AM, showing greatest variations between 2PM and 6PM. A similar trend is observed between 10AM and midnight on rainy days, with people''s activities found to be most diverse on days with heaviest rainfalls or on days when the wind speed was stronger than 4 km/h, especially between 10AM–1AM. Finally, we observed that different geographical areas of a large metropolis were impacted differently by the weather. Using data of urban infrastructure to characterize areas, we found strong correlations between weather conditions upon people''s accessibility to trains. This study sheds new light on the influence of weather conditions on human behavior, in particular the choice of daily activities and how mobile phone data can be used to investigate the influence of environmental factors on urban dynamics.